title: Combination of alpha-1-acid glycoprotein and alpha-fetoprotein as an improved diagnostic tool for hepatocellular carcinoma.
abstract: BACKGROUND
  To evaluate the diagnostic value of alpha-1-acid glycoprotein (AAG) and the combination with alpha-fetoprotein (AFP) in hepatocellular carcinoma (HCC) patients.
  
  
  METHODS
  AAG was measured in serum of 65 HCC patients and 54 chronic liver diseases (CLD) patients by using proteomic approach. Sensitivity and specificity of AAG and its combination with AFP were determined and compared with AFP alone for the diagnosis of HCC.
  
  
  RESULTS
  The expression concentration of AAG was significantly higher in HCC patients than chronic liver disease with sensitivity (77%) and accuracy (83%). Receiver operating characteristic analysis yielded the following AUC: AFP 0.750 (CI 95% 0.663-0.837), AAG 0.907 (CI 95% 0.855-0.960) and AFP+AAG 0.943 (CI 95% 0.897-0.988). At a specificity of 90%, the combination of AFP+AAG had sensitivity 89% and accuracy 90%, which was higher than sensitivity (52.3%) and accuracy (70%) when using AFP alone.
  
  
  CONCLUSIONS
  The combination of AAG and AFP shows high sensitivity and improves the accuracy of HCC diagnosis.
authors.affiliation: Mochtar Riady Institute for Nanotechnology, Lippo Karawaci, Banten, Indonesia.
authors.forename: Indra
authors.initials: I
authors.lastname: Bachtiar
authors.forename: Julian Mulya
authors.initials: JM
authors.lastname: Santoso
authors.forename: Benny
authors.initials: B
authors.lastname: Atmanegara
authors.forename: Rino Alvani
authors.initials: RA
authors.lastname: Gani
authors.forename: Irsan
authors.initials: I
authors.lastname: Hasan
authors.forename: Laurentius Adrianto
authors.initials: LA
authors.lastname: Lesmana
authors.forename: Ali
authors.initials: A
authors.lastname: Sulaiman
authors.forename: Jianren
authors.initials: J
authors.lastname: Gu
authors.forename: Susan
authors.initials: S
authors.lastname: Tai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000097:blood / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009961:Orosomucoid / Q000032:analysis*; D012680:Sensitivity and Specificity; D000509:alpha-Fetoproteins / Q000032:analysis* / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D009961:Orosomucoid; D000509:alpha-Fetoproteins